@layout("/common/_form.html",{js:["/assets/manager/flowCoupon/flowCoupon_edit.js"]}){

<form class="layui-form" id="flowCouponForm" lay-filter="flowCouponForm">
    <div class="layui-fluid" style="padding-bottom: 75px;">
        <div class="layui-card">
            <div class="layui-card-header">基本信息</div>
            <div class="layui-card-body">
                <div class="layui-form-item layui-row">
                    <input name="couponId" type="hidden"/>
                    <input name="memberId" id="memberId" type="hidden" />
                    <input name="orderId" id="orderId" type="hidden" />
                    <input name="serviceType" id="serviceType" type="hidden" />
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">优惠卷名<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="couponTitle" name="couponTitle" placeholder="请输入优惠卷名" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">优惠卷码<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="couponCode" readonly="readonly" name="couponCode" placeholder="请输入" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">金额<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="moneys" name="moneys" placeholder="请输入金额" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">是否使用<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <select id="isUsed" name="isUsed" lay-filter="isUsed">
                                <option value="0">未使用</option>
                                <option value="1">已使用</option>
                            </select>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label"><span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <select id="isGet" name="isGet" lay-filter="isGet">
                                <option value="0">未获得</option>
                                <option value="1">已获得</option>
                            </select>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">得到时间<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="getTime" name="getTime" placeholder="请输入得到时间" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">使用时间<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="useTime" name="useTime" placeholder="请输入使用时间" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">使用金额<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="onprice" name="onprice" placeholder="请输入使用金额" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">过期天数<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="outDay" name="outDay" placeholder="请输入过期天数" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">过期时间<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="endTime" name="endTime" placeholder="请输入过期时间" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                </div>
            </div>
        </div>
    </div>
    <div class="form-group-bottom text-center">
        <button class="layui-btn" lay-filter="btnSubmit" lay-submit>&emsp;提交&emsp;</button>
        <button type="reset" class="layui-btn layui-btn-primary" ew-event="closeDialog">&emsp;取消&emsp;</button>
    </div>

</form>

@}